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From the bench to the field: control of parasitic infections within primary health care

Published online by Cambridge University Press:  06 April 2009

M. Tanner
M. Tanner
Affiliation:
Swiss Tropical Institute, Department of Public Health and Epidemiology, 4002 Basel, Switzerland
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Summary

During the last decade there has been a great increase in the number of countries that have endorsed the primary health care (PHC) policy at national level, set up national guidelines for it and launched its large-scale implementation. In addition, there have been many important developments with regard to appropriate, cost-effective technologies, training concepts and approaches to securing community participation. These achievements have produced numerous encouraging results. However, although the control of parasitic infections integrated into PHC systems has often been initially successful, these achievements could often not be sustained. Using case studies, mainly concerning schistosomiasis, as examples, control technologies and their applicability within PHC are discussed at three levels; the identification of public health priorities, the community-based implementation of control and the process of evaluation and monitoring. There is a great potential for the integration of a substantial part of control activities, particularly morbidity control, into PHC, provided that the aims and sequences of control activities are well matched with the felt needs of the communities concerned. This implies that the biomedical researcher, the epidemiologist and the health planner need to consider the indigenous health perspectives of the affected community. For example, recent progress in the laboratory in the development of vaccines against parasites needs to be complemented by field studies that continuously validate, standardize and assess the applicability of the proposed measures. This kind of interplay will form the basis for participatory approaches in health planning and make it possible for control activities to be integrated into existing PHC structures and to respond to the needs of the communities concerned.

Keywords

health careschistosomiasiscost-effective controlfield parasitology
Type
Research Article
Information
Parasitology , Volume 99 , supplement S1: Symposium of the British Society for Parasitoiogy and the Linnean Society Special Issue: Research developments in the study of parasitic infections , January 1989 , pp. S81 - S92
Copyright
Copyright © Cambridge University Press 1989

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References

REFERENCES

Alonso, P. L., Bowman, A., Marsh, K. & Greenwood, B. M. (1987). The accuracy of the clinical histories given by mothers of seriously ill African children. Annals of Tropical Paediatrics 7, 187–9.CrossRefGoogle ScholarPubMed
Bonair, A., Rosenfield, P. & Tengvald, K. (1989). Medical technologies in developing countries: issues of technology development, transfer, diffusion and use. Social Science and Medicine (in the Press).Google Scholar
Borel, Ch. & Hostettmann, K. (1987). Molluscicidal saponins from Swartzia madagascariensis (Desvaux). Helvetica Chimica Acta 70, 570–6.CrossRefGoogle Scholar
Brenan, J. P. M. (1967). Leguminosae, subfamily Caesalpinoidae. In Flora of Tropical East Africa (ed. Milne-Redhead, E. & Polhill, R. M.), pp. 218–20. London: Crown Agents for Overseas Governments.Google Scholar
Brown, G. (1988). Assessment of immunity (protection) against malaria. Working Paper for Joint FIELDMAL/IMMAL Meeting on Immunological Aspects of Malaria Epidemiology. Geneva: WHO/TDR documents (n/d).Google Scholar
Burki, A., Tanner, M., Burnier, E., Schweizer, W., Meudt, R. & Degrémont, A. A. (1986). Comparison of ultrasonography, intravenous pyelography and cystoscopy in detection of urinary tract lesions due to Schistosoma haematobium. Acta Tropica 43, 139–51.Google ScholarPubMed
Burkot, T. R., Graves, P. M., Cattani, J. A., Wirtz, R. A. & Gibson, F. D. (1987). The efficiency of sporozoite transmission in the human malarias, Plasmodium falciparum and P. vivax. Bulletin of the World Health Organization 65, 375–80.Google ScholarPubMed
Cook, J. A. (1987). Strategies for control of human schistosomiasis. In Schistosomiasis (ed. Mahmoud, A. A. F.). Clinical Tropical Medicine and Communicable Diseases 2, 449–63.Google Scholar
Degrémont, A. A., Burki, A., Burnier, E., Schweizer, W., Meudt, R. & Tanner, M. (1985). Value of ultrasonography in investigating morbidity due to Schistosoma haematobium infection. Lancet i 662–5.CrossRefGoogle Scholar
Degrémont, A., Lwihula, G. K., Mayombana, Ch., Burnier, E., De Savigny, D. & Tanner, M. (1987). Longitudinal study on the health status of children in a rural Tanzanian community: comparison of community-based clinical examinations, the diseases seen at village health posts and the perception of health problems by the population. Acta Tropica 44, 175–90.Google Scholar
Del Giudice, G., Grau, G. E. & Lambert, P. H. (1988). Host responsiveness to malaria epitopes and immunopathology. In Malaria Immunology (ed. Perlmann, P. & Wigzell, H.). Progress in Allergy 41, 288–330. Basel: Karger.Google Scholar
Dixon, H. (1985). Statistical methods applicable to schistosomiasis control programmes. WHO/SCHISTO/85.81 and WHO/ESM/85.1 (unpublished document).Google Scholar
Feachem, R. G., Graham, W. J. & Timaeus, I. (1987). Identifying health problems and health research priorities in developing countries. Background paper for the Independent International Commission on Health Research for Developing Countries. London.Google Scholar
Feuerstein, M.-T. (1986). Partners in Evaluation, Evaluating Development and Community Programmes with Participants. London: Macmillan.Google Scholar
Greenwood, B. M. (1988). Correlation between immune response to P. falciparum and protection and their development in human populations. Working Paper for Joint FIELDMAL/IMMAL Meeting on Immunological Aspects of Malaria Epidemiology. Geneva: WHO/TDR documents (n/d).Google Scholar
Greenwood, B. M., Bradley, A. K., Greenwood, A. M., Byass, P., Jameh, K., Marsh, K., Tulloch, S., Oldfield, F. S. J. & Hayes, R. (1987). Mortality and morbidity from malaria among children in a rural area of The Gambia, West Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene 81, 478–86.Google Scholar
Heggenhougen, H. K. (1984). Will primary health care efforts be allowed to succeed? Social Science and Medicine 19, 217–24.Google Scholar
Heggenhougen, H. K. & Shore, L. (1986). Cultural components of behavioral epidemiology: implications for primary health care. Social Science and Medicine 22, 1235–45.Google Scholar
Hockmeyer, W. T. & Ballou, W. R. (1988). Sporozoite immunity and vaccine development. In Malaria Immunology (ed. Perlmann, P. & Wigzell, H.) Progress in Allergy 41, 1–14. Basel: Karger.CrossRefGoogle Scholar
Holland, W. W. (1983). Evaluation of Health Care. Oxford: Oxford University Press.Google Scholar
Homeida, M. A., Ahmed, S., Dafalla, A., Suliman, S., Eltom, I., Nash, T. & Bennett, J. L. (1988). Morbidity associated with Schistosoma mansoni infection as determined by ultrasound: a study in the Gezira, Sudan. American Journal of Tropical Medicine and Hygiene (in the Press).Google Scholar
Jackson, L. C. (1985). Malaria in Liberian children and mothers: biocultural perceptions of illness vs clinical evidence of disease. Social Science and Medicine 20, 1281–7.Google Scholar
Lwihula, G. K. (1985). Human behavior factors associated with transmission and control of Schistosoma haematobium in the Ifakara area, Morogoro, Tanzania. Ph.D. thesis, University of London.Google Scholar
Marti, H. P. (1986). Field observations on the population dynamics of Bulinus globosus, the intermediate host of Schistosoma haematobium in the Ifakara area, Tanzania. Journal of Parasitology 72, 119–24.CrossRefGoogle ScholarPubMed
Marti, H. P., Tanner, M., Degrémont, A. A. & Freyvogel, T. A. (1985). Studies on the ecology of Bulinus globosus, the intermediate host of Schistosoma haematobium in the Ifakara area, Tanzania. Acta Tropica 42, 171–87.Google ScholarPubMed
Morley, D., Rohde, J. & Williams, G. (1983). Practising Health for All. Oxford, New York and Toronto: Oxford University Press.Google Scholar
Mott, K. E. (1984). Schistosomiasis; a primary health care approach. World Health Forum 5, 221–5.Google Scholar
Mott, K. E. (1987). Schistosomiasis control. In The Biology of Schistosomes: from Genes to Latrines (ed. Rollinson, D. & Simpson, A. J. G.), pp. 431–50. London: Academic Press.Google Scholar
Mott, K. E., Dixon, H. & Osei-Tutu, E. (1985). Evaluation of reagent strips in urine tests for detection of Schistosoma haematobium infection; a comparative study in Ghana and Zambia. Bulletin of the World Health Organization 63, 125–33.Google ScholarPubMed
Mozely, A. (1939). Fresh water mollusca of the Tanganyika Territory and the Zanzibar Protectorate, and their relation to human schistosomiasis. Transactions of the Royal Society, Edinburgh 59, 687–730.Google Scholar
Nichter, M. (1984). Project community diagnosis: participatory research as a first step towards community involvement in primary health care. Social Science and Medicine 19, 237–52.CrossRefGoogle ScholarPubMed
STIFL(Swiss Tropical Institute Field Laboratory) and District Health Office (1985). Collaborative primary health care project in Kilombero District, Tanzania. Working Document STIFL No. 1.Google Scholar
Suter, R. (1986). The plant molluscicide Swartzia madagascariensis and its application in transmission control measures against Schistosoma haematobium; experience from Kikwawila (Kilombero district, Tanzania). Ph.D. thesis, University of Basel.Google Scholar
Suter, R., Tanner, M., Borel, Ch., Hostettmann, K. & Freyvogel, T. A. (1986). Laboratory and field trials at Ifakara (Kilombero district, Tanzania) on the plant molluscicide Swartzia madagascariensis. Acta Tropica 43, 69–83.Google ScholarPubMed
Tanner, M. (1988). District-level data collection and use. Commissioned paper for Independent International Commission on Health Research for Development. Boston: Harvard School of Public Health (n/d).Google Scholar
Tanner, M. (1989). Evaluation and monitoring of schistosomiasis control. Tropical Medicine and Parasitology 40 (in the Press).Google Scholar
Tanner, M. & Degrémont, A. (1986). Monitoring and evaluating schistosomiasis control within a primary health care programme. Tropical Medicine and Parasitology 37, 220–2.Google ScholarPubMed
Tanner, M. & De Savigny, D. (1987). Monitoring of community health status: experience from a case study in Tanzania. Acta Tropica 44, 261–70.Google Scholar
Tanner, M., Lwihula, G. K., Burnier, E., De Savigny, D. & Degrémont, A. A. (1986). Community participation within a primary health care programme. Tropical Medicine and Parasitology 37, 164–7.Google Scholar
Tanner, M., Degrémont, A., De Savigny, D., Freyvogel, T. A., Mayombana, C. & Tayari, S. (1987 a). Longitudinal study on the health status of children in Kikwawila village, Tanzania: study area and study design. Acta Tropica 44, 119–36.Google Scholar
Tanner, M., Burnier, E., Mayombana, C., Betschart, B., De Savigny, D., Marti, H. P., Suter, R., Aellen, M., Luedin, E. & Degrémont, A. A. (1987 b). Longitudinal study on the health status of children in a rural Tanzanian community, parasitoses and nutrition following control measures against intestinal parasites. Acta Tropica 44, 137–74.Google Scholar
Tanner, M., De Savigny, D., Mayombana, C., Hatz, C., Burnier, E., Tayari, S. & Degrémont, A. A. (1989). Morbidity and mortality at Kilombero; a district-based research-cum-action programme. Working paper for consultation on disease and mortality in sub-Saharan Africa: levels, trends and data deficiencies. Tunbridge Wells 1987. Washington: World Bank (in the Press).Google Scholar
Vaughan, P., Mills, A. & Smith, D. (1984). District health planning and management. EPC Publication No. 2. London: Evaluation and Planning Center, London School of Hygiene and Tropical Medicine.Google Scholar
Walsh, J. & Warren, K. S. (1986). Strategies for Primary Health Care. Chicago: University of Chicago Press.Google Scholar
Watt, J. M. & Breyer-Brandwijk, M. G. (1962). The Medical and Poisonous Plants of Southern and Eastern Africa. Edinburgh: E. & S. Livingstone.Google Scholar
Werner, D. (1980). Health care and human dignity – a subjective look at community-based rural health programmes in Latin America. Contact Special Series No. 3. Geneva: CMC and WCC.Google Scholar
World Health Organization (1978). Declaration of Alma Ata (report on the international conference on primary health care, Alma Ata, USSR, 6–12 September 1978).Geneva:WHO Publications.Google Scholar
World Health Organization (1982). Review of primary health care development. WHO Offset Publication SHS/82.3. Geneva: WHO Publications.Google Scholar
World Health Organization (1983). Mimimum evaluation procedures for water supply and sanitation projects. WHO Publication ETS/83.1 and CDD/ORP/83.1. Geneva: WHO Publications.Google Scholar
World Health Organization (1984). Strengthening ministries of health for primary health care. Offset Publication 82. Geneva: WHO Publications.Google Scholar
World Health Organization (1987). Declaration on strengthening district health systems based on primary health care. Geneva: WHO Publications.Google Scholar
World Health Organization (1988). From Alma-Ata to the year 2000: a midpoint perspective. Riga: WHO documents (n/d).Google Scholar